Public health leadership and electronic cigarette users.

Abstract

The recent study by Goniewicz and colleagues1 points to the increasing popularity of electronic cigarettes among people who want to quit smoking, adds to the growing scientific evidence about their real-world use and in turn raises questions about their potential to reduce smoking-related disease. Smoking is the leading cause of preventable death and disease globally, associated with nearly 6 million deaths annually; in the European Union smoking rates average 29% of the adult population, with 700 000 premature deaths each year. Most smokers want to quit smoking but find it hard to give up nicotine. Progress with reducing smoking continues, but the pace is slow. It is hard to see how the current non-communicable disease burden can be met without a drastic reduction in smoking prevalence. It is also hard to see how that can come about with current anti-smoking measures. The package of interventions in the European Tobacco Products Directive, including large health warnings and bans on small packs, is on the evidence of the European Commission’s own impact assessment likely to reduce tobacco consumption only by ∼2% over 5 years, which translates into ∼0.5% decline in prevalence in that time. Elsewhere, similarly modest historical gains have …